FL H0831

Agency for Health Care Administration (AHCA) must implement a Medicaid managed care pilot program for individuals with developmental disabilities in Statewide Medicaid Managed Care Regions D and I, with federal approval requests due by September 1, 2023, and plan selection and enrollment beginning no later than January 2024

Eligible participants must be Medicaid-eligible adults aged 18 or older who reside in a pilot region and are on the waiting list for individual budget waiver services under chapter 393 (categories 1–6); participation is voluntary and capped at the number specified in the General Appropriations Act

Participating managed care plans must cover comprehensive services through a single integrated model, including standard Medicaid and long-term care benefits plus 26 specific community-based services such as adult day training, behavior analysis, residential habilitation, supported employment, respite care, and support coordination

One plan per region will be selected through an invitation to negotiate, with preference given to plans demonstrating experience serving developmental disabilities populations, robust provider networks, person-centered planning programs, and community partnerships; plans receive actuarially sound per-member, per-month capitated payments

AHCA must submit progress reports to the Governor and Legislature by December 31, 2023 (federal approval status), December 31, 2024 (implementation status), and annually beginning December 31, 2025 (operations), with a full program evaluation due by October 1, 2029, assessing cost savings, quality of care, access to services, and health outcomes